A previously used technique for daily monitoring of salient behaviors as indicators of effectiveness and behavioral toxicity of drug therapy in retarded patients will be adapted for use in nursing home patients. Direct care staff will specify up to 18 behavioral and/or health variables as assets to be preserved or as problems to be remedied to reflect the individual needs and goals for each patient and will complete a daily report sheet on those variables. One or more indicators of cognitive function, possible depression and physical health are included for each patient. A specialized computer program transforms the raw data on each variable, regardless of content or format, into a common metric system of standard scores based upon the day-to-day variability for each variable x patient x rater combination. The daily standard scores for all variables in each category (e.g., cognitive function) are averaged to indicate changes over time and to contrast the level of function in each category before and after dose increases and decreases in specific drugs or combinations. Monthly reports are submitted to the nursing home and to the rsponsible physician showing month-to-month changes in each variable and category and the probability that changes associated with medication adjustments are within the range of day-to-day variability for that individual. The physician is provided a computorized annotated bibliography on suspected behavioral toxicity of drugs actually used for each patient as encouragement for moderate drug use and as a stimulant for trial drug reductions that can be analyzed to provide further pilot data on possible drug toxicities. The project will include assessment of inter-observer reliability and validity of the monitoring technique in a nursing home setting. Increases and decreases in actual drug use among monitored patients will be compared with unmonitored patients to test the influence of monitoring and information feed-back on the prescription practices of primary physicians.